A physician is one of the most respected careers, but like others, they also face difficulties. In a new book titled Himalai Tong Klub Pai Fung (Himalayan Health Exchange II) published by Salmon Books, Dr Kamphee Sruamsiri, a freelance emergency physician, wrote about his identity crisis which led him to participate in the Himalayan Health Exchange (HHE), a medical service that brings international healthcare professionals and students to treat people who live in remote areas of the Indian Himalayas and Indo-Tibetan borderlands.
It was not the first time that Dr Kamphee participated in HHE. He was with the group several years ago and published a book in 2014 about HHE titled Himalai Tong Chai Hu Fung (Himalayan Health Exchange I). In Himalayan Health Exchange II, Dr Kamphee worked with healthcare professionals at 15 clinics and examined 2,736 patients.
Life spoke with Dr Kamphee about his experiences at the HHE and India.
What made you interested in emergency medicine?
While I was a medical student, I felt instant gratification. If I provided the right treatment, patients' health conditions improved right in front of me. I did not have to wait for a long time. I liked this feeling. Also, an emergency medicine physician's work hours are fixed. We do not have to go to a hospital on call, except in the case of a massive emergency accident which does not happen often.
Why did you decide to be a freelance medical physician?
I planned to study in the US to enhance my resume by selecting an elective abroad for a period of time. If I worked as a full-time medical doctor, it would be difficult to take days off. Thus, I decided to work as a freelancer at hospitals in different provinces. After that, I got used to it. Also, I could fix my schedule to have several days off for travel.
What made you decide to participate in the HHE the first time?
I heard about the HHE when I was taking an elective in the US and searched more about it on the internet. It is a healthcare service in remote areas that have limited equipment and medicine, so healthcare professionals depend on physical examination more often than usual. I thought the project was interesting. After I attended the HHE, many people in Thailand asked me about it. Since it involved a lot of detail, I wrote stories from my journal and it became the first book.
Can you tell us about your identity crisis?
I felt like other people I know had achieved their goals. Some received promotions, had families and provided help to people. In contrast, I just worked and travelled. Many people said they could relate to my struggles because everyone can see the achievements of other people via social media. My first time at the HHE was a delightful experience and I met excellent teammates. Hence, I wanted to do some good deeds and thought that participating in the HHE might make me feel better.
What were some of the charms of India?
It was fascinating to see different religious sites in the same location. You can see a Hindu temple next to a Buddhist temple and not far away is the worship of a goddess. I also learned that there are several kinds of bread in India such as naan, roti, dosa and chapati. Indian people do not have a sense of personal space. Taxi drivers asked me personal questions and many Indians liked to stand close to me. Although India would not be my first travel destination when the pandemic situation improves, I still want to visit Varanasi to see the Ganges River.
You brought a portable handheld ultrasound scanner to the HHE. Was that necessary equipment?
No, but it is helpful in providing medical tests and patients are happy and feel better after doctors use it. In some cases, it is not really effective. For example, if a patient must have an abdominal ultrasound exam, they should fast before, but patients in rural areas do not prepare for that. If possible, I hope to see stethoscopes that can record sounds and an electrocardiogram at the HHE.
What was it like when you had to examine children with special needs?
As an emergency medicine doctor, I rarely met children with special needs. Thus, it was an eye-opening experience. Since some children with special needs could not communicate with us, we had to trick them when we wanted to examine them. For example, when we wanted to test if they could move their arms and legs, we handed an item to them.
What was it like to visit people in remote areas of India?
During my first HHE, we had to walk two days from the road. If people in that area wanted to see a doctor, they spent two days on foot and had to take a vehicle to a hospital. People who live in remote areas also have hygiene problems and children's weight and height do not meet the WHO's growth standard.
Have you ever experienced miscommunication due to language differences?
When I was at the HHE, physicians and other medical staff sometimes had to communicate with patients through interpreters who translated from Tibetan to Hindi and then to English. I think there were probably things lost in translation, but I had no idea if there was a misinterpretation or not.
Regarding language differences, I once had an English-speaking patient and when I asked how much his weight was, instead of telling me in pounds or kilogrammes, he answered in stones. I was surprised and it took me time to realise that stone is a weight measurement. That was something new. Working in a hospital located in a tourist spot exposed me to new words and languages.
Can you tell us more about menstrual stigma in India?
I watched the documentary Period. End Of Sentence which looks at the stigma around menstruation in rural areas in India. The documentary is about a group of women who try to distribute sanitary pads and share knowledge about menstruation with people in rural areas. I was surprised to see that women who have their menstrual cycle are not allowed to enter their homes. At the HHE, when we had examinations for priestesses at a temple, a physician assistant who could speak Hindi had to lecture them about menstruation. That reminded me about the documentary. I also realised that menstruation is not basic knowledge in India.
You travelled to more than 30 countries. What did you gain from travelling?
It opened up a new world and allowed me to experience diverse cultures and people. Unexpected situations during the journey enhanced my problem-solving skills. I learned how to communicate with people and handle situations.
When Bali airport was closed due to volcanic ash, I had to postpone a flight and change a hotel reservation. People who do not have this kind of experience may not know what to do. When I was in Rome and Paris, pickpockets tried to steal from me, but they did not get anything from me. I put my items separately. My wallet was inside a fanny pack and I held on to my phone which was in my pants pocket.
